Jeffrey Martens, PH.D.

Key facts

NPI

1467726802

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Psychologist 103TC0700X

License

0810007363 (VA)

Practice address

12359 Sunrise Valley Dr Ste 320
Reston, VA 20191-3463

Phone

(757) 932-7535

Fax

(703) 787-8210

NPI assigned

Mar 2, 2012

Sex

Male

Sole proprietor

Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• My Psychiatrist LLC Mental Health Clinic/Center (Including Community Mental Health Center) · Reston, VA · NPI 1295048684
  Medicare reassignment Care Compare group NPD DC

Medicare Care Compare profile

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

My Psychiatrist, LLC (15 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 23, 2021.

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1467726802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12359 SUNRISE VALLEY DR STE 320",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913463",
            "telephone_number": "757-932-7535",
            "fax_number": "703-787-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12359 SUNRISE VALLEY DR STE 320",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913463",
            "telephone_number": "757-932-7535",
            "fax_number": "703-787-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTENS",
        "first_name": "JEFFREY",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-02",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "05063",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

• Jessica Marmo, RDN
• Ralph Maroun, MD
• Eveline B Marquardt, M.D.
• Gabriela Marquez Canale, LCSW
• Maritza Marrero Gonzalez
• Kathleen Reindl Martens, PSYD
• Jessica Martin, DMD
• Meghan Martin, FNP
• Sheila Marie Martin, CRNA
• Luis J. Martinez, D.D.S.

All providers in Reston, VA · Clinical Psychologist in Virginia